Flick et al. disclose in U.S. Pat. No. 6,739,001 a mattress system 10 having a fluid cushion 12 connected to a first restraint 14 and a second restraint 16 positioned on a patient support device 17 (i.e., a bed frame) with railings 18 as illustrated in FIG. 1.
The fluid cushion 12 has a head end 20, a foot end 22, a middle area 24, a right side 26, a left side 28, a top surface 30 and a bottom surface 32. The fluid cushion can be a plurality of air bladders, an air bladder with interior welds, low loss air bladders with or without interior welds, or any other conventional fluid cushion material. Examples of such cushions include and are not limited to Gaymar Industries, Inc.'s Airflo pad, Paradise pad, and Aire-Twin mattress bladders.
The first restraint 14 is positioned on the cushion's right side 26 and the second restraint 16 is positioned on the cushion's left side 28. Respectively, the restraints 14, 16 can (a) extend the entire length of the right side 26 and left side 28 as illustrated in FIG. 2; or (b) be positioned at (i) the head end on both sides 26, 28 as illustrated in FIG. 3; (ii) the foot end on both sides 26, 28 as illustrated in FIG. 4; or (iii) the head end and the foot end on both sides 26, 28 with no restraints at the middle area 24 as illustrated in FIG. 5. The last embodiment was desired to allow the patient a path to egress from the cushion 12.
The restraints 14, 16 have a top surface 50, a bottom surface 52, an interior surface 54 and an exterior surface 56. The restraints 14, 16 can be fluid bladders, foam, foam beads, gels, batting, or other suitable materials for inhibiting and/or restraining a user from rolling (a) off the long term support device 17 and/or (b) into the area between the fluid cushion 12 and the railing 18. What ever the restraint material, the restraints 14, 16 are attached and/or interconnected to the cushion 12 to ensure the restraints perform as a restraint.
Where the cushion attaches and/or interconnects to the restraints is a critical issue. Flick et al. explicitly disclose the cushion's top surface 30 is always below the restraint's top surface 50.
Gaymar Industries, Inc. has learned that a restraint makes it difficult to transfer a patient. Many individuals complain about lifting a patient over the restraint member.
For a number of years, Gaymar has been manufacturing its Sof-Matt RSM Low-Air-Loss Mattress System as illustrated in FIGS. 6a, 6b and 7. That mattress system has foam crib 60 surrounding a plurality of deep cell air bladders 62 interconnected to an air pump (not shown). Deep cell air bladders are a minimum of 5 inches tall. The foam crib 60 has a top surface 64. The air bladder 62 also has a top surface 66 and interconnects 68 to the foam crib 60 at and/or near the bladder's top surface 66 to the restraint's top surface 64 as illustrated in FIG. 6. That interconnection 68 position was deemed critical to provide lateral stability to the mattress system to make it easier for the patient to get in and out of bed and facilitating patient transfers.
The air pump provides air to the air bladder at least at two different inflation modes. The first inflation mode is referred to as maximum volume. At maximum volume, the air bladder's top surface 66 is planar to the crib's top surface 64 as illustrated in FIG. 6a. The second inflation mode, as illustrated in FIG. 7, is referred to as normal operating mode. Normal operating mode provides sufficient inflation to prevent the patient from bottoming out when not desired and sufficient pressure to decrease the formation of debuticus ulcers. (“Bottoming” refers to any state where the bladder's top surface 66 is depressed to a point that it contacts the bladder's lower surface 67, thereby markedly increasing the interface pressure where the two surfaces contact each other and is not desired unless CPR needs to be administered.) The normal operating mode in the current embodiment of Gaymar's Sof-Matt RSM Low-Air-Loss Mattress System creates a hammock effect. The hammock effect increases tissue interface pressure, which is normally undesirable. Since the crib and bladders only form a hammock effect in the normal operating mode, the crib in Gaymar's Sof-Matt RSM Low-Air-Loss Mattress System is not a restraint because the patient can roll (a) off the patient support device 17 or (b) into a position between the crib and the bed railing. Obviously these results are undesirable.